| NPI | 1689885659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: FL ME149086) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 33413) |
| 207Y00000X Otolaryngology (Licence: FL ME149086) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: SC 33413) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2023-02-17 |